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Extra-abdominal involvement is associated with antitubercular therapy-related hepatitis in patients treated for

Saurabh Dawra¹, Harshal S Mandavdhare¹, Harjeet Singh¹

¹Department of Gastroenterology and General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Clinical and Experimental Hepatology

|March 28, 2019

Abstract

Aim Of The Study:

Incidence and predictors of antitubercular therapy (ATT)-related hepatitis in abdominal tuberculosis are not known. The aim of the study was to identify the incidence and predictors of ATT-induced hepatitis in abdominal tuberculosis.

Material And Methods:

A retrospective analysis of patients who received ATT for suspected abdominal tuberculosis with complete follow-up was done. We excluded patients with underlying chronic or acute liver disease necessitating an alteration in the usual ATT at start. We recorded the occurrence of ATT-induced hepatitis and compared patients with and without ATT hepatitis for any predictors of ATT-induced hepatitis.

Results:

Of 163 patients, 22 were excluded (17 missing information, 5 chronic liver disease). One hundred and forty-one patients (mean age: 34.33 ±15.18 years, males: 72) were included. The Mantoux test was positive in 78; 1 had HIV and 32 had an abnormal chest X-ray. Six patients had an alternative diagnosis and 11 needed surgery. Forty-nine (34.8%) had extra-abdominal involvement. Ten patients (7.1%) developed ATT-induced hepatitis. Patients with extra-abdominal tubercular involvement had a greater risk of developing ATT-induced hepatitis (p-value 0.003). None of the other parameters including hematological tests, liver function tests and biochemical parameters were different between the two groups.

Conclusions:

Seven percent of patients treated for abdominal tuberculosis developed ATT hepatitis. Presence of extra-abdominal involvement was associated with ATT hepatitis.

Keywords:

drug-induced liver injury hepatitis intestinal tuberculosis peritoneal tuberculosis tuberculosis

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